HIRAID Inpatient framework reduces preventable nurse-associated clinical deterioration and hospital-acquired complications in acutely unwell inpatients
This protocol describes a stepped-wedge cluster RCT evaluating the HIRAID Inpatient framework across 35 wards in 10 hospitals with 1259 nurses and 4050 patients per month. The study aims to reduce preventable nurse-associated clinical deterioration and hospital-acquired complications by standardizing nursing assessment, decision-making, and communication.
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HIRAID Inpatient framework reduces preventable nurse-associated clinical deterioration and hospital-acquired complications in acutely unwell inpatients The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
HIRAID Inpatient framework reduces preventable nurse-associated clinical deterioration and hospital-acquired complications in acutely unwell inpatients
This conclusion is most relevant to: Acutely unwell inpatients admitted to 35 wards across 10 hospitals in two Australian states, with 4050 admissions per month.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Implementation evaluation of an evidence-informed hospital inpatient nursing framework (HIRAID® Inpatient): a protocol for a stepped-wedge cluster RCT. (Trials, 2026) —
How It Works
The proposed biological pathway:
- ▸Standardized nursing assessment framework implemented
- ▸Nurses use evidence-informed decision-making and action protocols
- ▸Improved recognition and response to clinical deterioration
- ▸Reduced adverse events and improved patient safety
Who Might Benefit
Evidence fit by population:
- ▸Acutely unwell inpatients admitted to 35 wards across 10 hospitals in two Australian states, with 4050 admissions per month
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Results are not yet available as this is a protocol paper
- ▸Stepped-wedge design may introduce temporal confounding if secular trends occur
- ▸Implementation fidelity may vary across 35 wards and 10 hospitals
Frequently Asked Questions
What is the HIRAID Inpatient framework?▼
It is an evidence-informed, standardized nursing framework for assessment, decision-making, and action adapted for hospital inpatient settings to improve patient safety.
How many hospitals and nurses are involved in this trial?▼
The trial involves 10 hospitals across three health services in two Australian states, with 1259 nurses from 35 inpatient wards.
What outcomes will be measured?▼
Primary outcomes include rates of preventable nurse-associated clinical deterioration, hospital-acquired complications, patient and carer experiences, and quality of nursing documentation and communication.
When will results be available?▼
This is a protocol paper; results are not yet reported. The trial was registered in June 2025, and the paper is from 2026.
References
- 1.Curtis K, Considine J, Lam MK, Wiseman T, McPhail S, Jones T, Mulholland B, Trostian B, Wright K, Kourouche S, Kennedy B, Clements A, Melville G, Ashford B, Brereton CJ, Bartlett A, Wand T, Pettigrew C, Zeitz K, Mitchell RJ, Shetty A, Lingam M, Saddington E, O'Reilly G, Smith S, Watts M, Shaban RZ. “Implementation evaluation of an evidence-informed hospital inpatient nursing framework (HIRAID® Inpatient): a protocol for a stepped-wedge cluster RCT..” Trials, 2026. PMID: 41339957 DOI: 10.1186/s13063-025-09313-8